The Pain is Real

One of the worst feelings is watching someone in pain and feeling helpless. As a pediatric physical therapist, I often wish I had a magic wand to wave and make it all go away. No child deserves to hurt, no child deserves sitting on the sidelines at recess. I can only imagine how those feelings are magnified when it is your child. All you want is to make them feel better and somehow nothing works. Then the pain starts to creep into all aspects of your life. Family outings start to look different, sleeping arrangements change, school is missed, siblings become frustrated because they feel held back or neglected, and a dangerous cycle begins-we begin to let pain define the child.

Too often children are told its “growing pains,” “you just want attention,” or “you are making it up.” Anyone in pain can tell you, they aren’t making it up. They would much rather be running, jumping, and playing. Is there a psychological component to chronic pain? Yes, most definitely yes. Does that mean they are fabricating pain? No, and that is where confusion often occurs. The brain is powerful and working with the psychological component can help us manage and cope with pain. Fibromyalgia, CRPS, and the ever-growing list of diagnoses, are all real and they each involve multiple systems of the body.

Chronic pain is a growing epidemic in our society.

Sadly, we are seeing this in younger and younger children. Our nervous system gets so ramped up we can’t turn it down. Imagine your house alarm system going off every team a leaf goes by, this is part of the mechanism with chronic pain. It is called central sensitization. We need to change the signals and change the understanding of your child’s pain.

We are seeing large and innovative medical centers, Boston Children’s, Mayo Clinic, Texas Children’s move to a multi-disciplinary approach to pain. Maybe children in pain weren’t getting better, not because it is imaginary but because we have been approaching it wrong. Maybe it is our fault as healthcare providers for not validating their pain and therefore not treating their pain correctly, maybe we should share the blame. We work best when we come together and share our talent, no one person has all the answers. When dealing with chronic pain and complicated presentations it is best to put together a team that includes a physician, physical therapist, licensed counselor, and other members as indicated (Dietitian, specialists such as neurology, internist, rheumatology). Not only should your child follow with a team, you need to ask that the team communicate with each other and make a cohesive plan.

Children in pain are strong, stronger than you realize. Their bodies want to heal but it takes a unique approach. Kylie Mcpherson said: “Being able to walk pain free is a blessing, being able to walk without showing the pain is a skill.” Remember, just because it doesn’t look like they are pain doesn’t meant they are not in pain, it means they are fighters. You never know who walking past you, what child at school is hiding excruciating pain.

If your child is in pain I want you to know three things:

There is a light at the end of the tunnel

They need you to advocate for them

It is going to take the whole family following a plan to see progress. You can’t do it for them and they can’t do it alone.

This is a long-term process.

Immediate steps to begin are:

work on improving sleep hygiene

focus on function

minimize check ins – let the child come to you instead of consistently asking how the child is feeling throughout the day

If they have managed to distract themselves from their pain we do not want to bring that to their attention by asking “what’s your pain level?”

put together a team you trust to treat your child

If you are on a chronic pain journey, or have a child who is, find a support group and find providers experienced with chronic pain who are willing to work together across the medical team.

About the author:
Kelsey Baas received her Doctorate of Physical Therapy at UT Southwestern. She spent 4.5 years working at Texas Children’s as a physical therapist before moving to Waco to open Compleo Physical Therapy & Wellness, a clinic that takes a multi-disciplinary approach to health and wellness. She is the first Schroth Scoliosis certified therapist in Waco and brings 2 years experience working in the Texas Children’s Chronic Pain Clinic. In her free time she loves to travel with her Husband, Warren, and take her dog, Collins, to the dog park.